How Doctors Responded to Being Named a Leading Killer

Sept 19 Doctors copy.jpeg

In my video Why Prevention Is Worth a Ton of Cure, I profiled a paper that added up all the deaths caused by medical care in this country, including the hundred thousand deaths from medication side effects, all the deaths caused by errors, and so on. The author of the paper concluded that the third leading cause of death in America is the American medical system.

What was the medical community's reaction to this revelation? After all, the paper was published in one of the most prestigious medical journals, the Journal of the American Medical Association, and was authored by one of our most prestigious physicians, Barbara Starfield, who literally wrote the book on primary care. When she was asked in an interview what the response was, Starfield replied that her primary care work had been widely embraced, but her findings on how harmful and ineffective healthcare could be received almost no attention.

This inspires the recollection of "the dark dystopia of George Orwell's 1984, where awkward facts are swallowed up by the 'memory hole' as if they had never existed at all." Report after report has come out, and the response has been a deafening silence both in deed and in word, failing to even openly discuss the problem, leading to thousands of additional deaths. We can't just keep putting out reports, we have to actually do something.

As I discuss in my video How Doctors Responded to Being Named a Leading Killer, the first report was published in 1978, suggesting about 120,000 preventable hospital deaths a year. The response? Silence for another 16 years until another scathing reminder was published. If we multiply 120,000 by those 16 years, we get 1.9 million preventable deaths, about which there was near total doctor silence. There was no substantial effort to reduce the number of those deaths. The Institute of Medicine (IOM) then released its landmark study in 1999, asserting that yet another 600,000 patients died during that time when providers could have acted.

Some things have finally changed. Work hour limits were instituted for medical trainees. Interns and residents could no longer be worked more than 80 hours a week, at least on paper, and the shifts couldn't be more than 30 hours long. That may not sound like a big step, but when I started out my internship, I worked 36 hour shifts every three days, 117-hour work weeks.

When interns and residents are forced to pull all-nighters, they make 36% more serious medical errors, five times more diagnostic errors, and have twice as many "attentional failures." That doesn't sound so bad, until you realize that means things like nodding off during surgery.

The patient is supposed to be asleep during surgery, not the surgeon.

Performance is impaired as much as a blood alcohol level that would make it illegal to drive a car--but these overworked interns and residents can still do surgery. No surprise there were 300% more patient deaths. Residents consider themselves lucky if they get through training without killing anyone. Not that the family would ever find out. With rare exceptions, doctors are unaccountable for their actions.

The IOM report did break the silence and prompted widespread promises of change, but what they did not do is act as if they really believed their own findings. If we truly believed that a minimum of 120 people every day were dying preventable deaths in hospitals, we would draw a line in the sand. If an airliner was crashing every day, we'd expect that the FAA would step in and do something. The Institute of Medicine could insistently demand that doctors and hospitals immediately adopt at least a minimum set of preventive practices--for example, bar-coding drugs so there aren't any mix-ups, like they do for even a pack of Tic Tacs at the grocery store. Rather than just going on to write yet another report, they could bluntly warn colleagues they would publicly censure those who resisted implementing these minimum practices, calling for some kind of stringent sanctions.

Instead, we get silence. But not for Barbara Starfield, who is unfortunately no longer with us. Ironically, she may have died from one of the adverse drug reactions she so vociferously warned us about. She was placed on aspirin and the blood-thinner Plavix to keep a stent she had to have placed in her coronary artery from clogging up. She told her cardiologist she was bruising more, bleeding longer, but those side effects are the risks you hope don't outweigh the benefits. Starfield apparently hit her head while swimming and bled into her brain.

The question for me is not whether she should have been on two blood-thinners for that long or even whether she should have had the stent inserted. Instead, I question whether or not she could have outright avoided the heart disease, which is 96% avoidable in women.

The number-one killer of women need almost never happen.


For those curious about my time in medical training, you can read my memoir of sorts, Heart Failure: Diary of a Third Year Medical Student.

It isn't just medical treatment that can be harmful. Even medical diagnosis can be dangerous, as I discuss in my video Cancer Risk From CT Scan Radiation.

And, just as we're (finally) seeing some changes in training protocols, the times, they are a-changin' with the emergence of the field of lifestyle medicine, as I present in several videos, including:

I recently made some videos to give people a closer look at why I believe it's so important for us to take responsibility for our own health. You can see all of them on our new Introductory Videos page.

I'm excited to be part of this revolution in medicine. Please consider joining me by supporting the 501c3 nonprofit organization that keeps NutritionFacts.org alive by making a tax-deductible donation. Thank you so much for helping me help so many others.

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Original Link

How Doctors Responded to Being Named a Leading Killer

Sept 19 Doctors copy.jpeg

In my video Why Prevention Is Worth a Ton of Cure, I profiled a paper that added up all the deaths caused by medical care in this country, including the hundred thousand deaths from medication side effects, all the deaths caused by errors, and so on. The author of the paper concluded that the third leading cause of death in America is the American medical system.

What was the medical community's reaction to this revelation? After all, the paper was published in one of the most prestigious medical journals, the Journal of the American Medical Association, and was authored by one of our most prestigious physicians, Barbara Starfield, who literally wrote the book on primary care. When she was asked in an interview what the response was, Starfield replied that her primary care work had been widely embraced, but her findings on how harmful and ineffective healthcare could be received almost no attention.

This inspires the recollection of "the dark dystopia of George Orwell's 1984, where awkward facts are swallowed up by the 'memory hole' as if they had never existed at all." Report after report has come out, and the response has been a deafening silence both in deed and in word, failing to even openly discuss the problem, leading to thousands of additional deaths. We can't just keep putting out reports, we have to actually do something.

As I discuss in my video How Doctors Responded to Being Named a Leading Killer, the first report was published in 1978, suggesting about 120,000 preventable hospital deaths a year. The response? Silence for another 16 years until another scathing reminder was published. If we multiply 120,000 by those 16 years, we get 1.9 million preventable deaths, about which there was near total doctor silence. There was no substantial effort to reduce the number of those deaths. The Institute of Medicine (IOM) then released its landmark study in 1999, asserting that yet another 600,000 patients died during that time when providers could have acted.

Some things have finally changed. Work hour limits were instituted for medical trainees. Interns and residents could no longer be worked more than 80 hours a week, at least on paper, and the shifts couldn't be more than 30 hours long. That may not sound like a big step, but when I started out my internship, I worked 36 hour shifts every three days, 117-hour work weeks.

When interns and residents are forced to pull all-nighters, they make 36% more serious medical errors, five times more diagnostic errors, and have twice as many "attentional failures." That doesn't sound so bad, until you realize that means things like nodding off during surgery.

The patient is supposed to be asleep during surgery, not the surgeon.

Performance is impaired as much as a blood alcohol level that would make it illegal to drive a car--but these overworked interns and residents can still do surgery. No surprise there were 300% more patient deaths. Residents consider themselves lucky if they get through training without killing anyone. Not that the family would ever find out. With rare exceptions, doctors are unaccountable for their actions.

The IOM report did break the silence and prompted widespread promises of change, but what they did not do is act as if they really believed their own findings. If we truly believed that a minimum of 120 people every day were dying preventable deaths in hospitals, we would draw a line in the sand. If an airliner was crashing every day, we'd expect that the FAA would step in and do something. The Institute of Medicine could insistently demand that doctors and hospitals immediately adopt at least a minimum set of preventive practices--for example, bar-coding drugs so there aren't any mix-ups, like they do for even a pack of Tic Tacs at the grocery store. Rather than just going on to write yet another report, they could bluntly warn colleagues they would publicly censure those who resisted implementing these minimum practices, calling for some kind of stringent sanctions.

Instead, we get silence. But not for Barbara Starfield, who is unfortunately no longer with us. Ironically, she may have died from one of the adverse drug reactions she so vociferously warned us about. She was placed on aspirin and the blood-thinner Plavix to keep a stent she had to have placed in her coronary artery from clogging up. She told her cardiologist she was bruising more, bleeding longer, but those side effects are the risks you hope don't outweigh the benefits. Starfield apparently hit her head while swimming and bled into her brain.

The question for me is not whether she should have been on two blood-thinners for that long or even whether she should have had the stent inserted. Instead, I question whether or not she could have outright avoided the heart disease, which is 96% avoidable in women.

The number-one killer of women need almost never happen.


For those curious about my time in medical training, you can read my memoir of sorts, Heart Failure: Diary of a Third Year Medical Student.

It isn't just medical treatment that can be harmful. Even medical diagnosis can be dangerous, as I discuss in my video Cancer Risk From CT Scan Radiation.

And, just as we're (finally) seeing some changes in training protocols, the times, they are a-changin' with the emergence of the field of lifestyle medicine, as I present in several videos, including:

I recently made some videos to give people a closer look at why I believe it's so important for us to take responsibility for our own health. You can see all of them on our new Introductory Videos page.

I'm excited to be part of this revolution in medicine. Please consider joining me by supporting the 501c3 nonprofit organization that keeps NutritionFacts.org alive by making a tax-deductible donation. Thank you so much for helping me help so many others.

In health,

Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Original Link

Inhibiting Platelet Activation with Tomato Seeds

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In the prevention of cardiovascular disease, the consumption of fruits and vegetables is crucial. Preventing the oxidation of cholesterol may be one of the mechanisms by which fruits and vegetables reduce the risk of heart attacks and strokes. However, hyperactivity of platelets is also critically important in the pathogenesis of cardiovascular disease, as I've covered before (See Inhibiting Platelet Aggregation with Berries).

In recent years, it has been shown that platelets are not only involved in the arterial clotting process, but also that they play an active role in the inflammatory process of atherosclerosis from childhood. By the end of our teens, atherosclerotic lesions are present in most people living in industrialized societies, and so suppressing the over-activity of platelets may be beneficial not only for heart disease, but for cancer, allergies, and diseases for which inflammation plays a major role.

The antioxidant properties of fruits and veggies are well known. However, their anti-clotting effects on platelets are less known. Preliminary studies have demonstrated the platelet activation suppressing activity of a variety of fruits and vegetables. They suppress platelet activation so well that they can actually mess up platelet function tests. And, the effects are so long-lasting that fasting the morning of your blood test may not be sufficient.

Out of 16 different fruits tested, tomatoes came out number one. The anti-platelet activation components in tomatoes are water soluble, so we don't have to eat them with fat; heat stable, meaning we can cook tomatoes without losing the benefits; and concentrated in the yellow fluid around the seeds. This is why tomato pomace beat out tomato juice, sauce, or ketchup. Pomace is basically the seeds and the peel, which the industry throws away, and it may be the healthiest part. And the more tomato seeds the better. But this study was measuring platelet activation in a petri dish. Grapefruit came in number two here, and grapefruit juice at least didn't appear to help when people actually drank it. Would drinking tomato juice actually help?

Platelets of patients with diabetes are characterized by intensified activation, so 20 diabetics were asked to drink a daily cup of tomato juice for three weeks or a tomato-flavored placebo beverage, and there was a significant drop in platelet activation.

A study done by the Rowett Research Institute, highlighted in my video, Inhibiting Platelet Activation with Tomato Seeds, found this works in healthy people as well. Within three hours of consumption, two tomatoes lowered platelet activation, and six tomatoes worked even better. Also, the effects were more wide-ranging than those of aspirin in that the tomatoes targeted multiple pathways of platelet activation.

About one in four people are aspirin resistant, meaning aspirin doesn't work to calm down their platelets, whereas only 3% of study subjects were found to be tomato resistant.

This finding indicates an advantage of the tomato extract's broad antiplatelet activity profile over single-target drugs such as aspirin. Also, when researchers stuck tubes into people while they were eating tomatoes, they found no changes in blood clotting times, implying that supplementation with tomatoes should not result in a prolonged bleeding times, so one might get the best of both worlds: less platelet activation without the bleeding risk. But if tomatoes don't thin our blood, do they work?

Researchers out of North Carolina State University report that, "consumption of tomato products has been found to be protectively correlated with a lower incidence of acute coronary events, less development of early atherosclerosis, and lower mortality from heart disease."

If you don't like tomatoes, kiwifruit recently beat them out in a test tube study of platelet activation. Strawberries may help too, but we have data showing kiwis may actually work in people, and two kiwis appeared to work just as well as three kiwis. It appears to work for green-on-the-inside kiwifruit; and for yellow-on-the-inside kiwifruit. In this case, though, one a day seemed to help whereas two-a-day did not, which seems a little strange. And there haven't been any studies to see if kiwifruit eaters actually have fewer strokes and heart attacks, so the best evidence for a dietary intervention to decrease platelet activation currently rests with tomatoes.

One of my favorite videos, The Tomato Effect, is actually not about tomatoes at all, but talks about the power of a diet composed entirely of plants to combat the heart disease epidemic. After all, Heart Disease Starts in Childhood.

I do have some others that really do touch on tomatoes, though:

More on kiwis here:

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, From Table to Able, and Food as Medicine.

Image Credit: Rusty Clark / Flickr

Original Link

The #1 Dietary Risk Factor is Not Eating Enough Fruit

NF-Jan28 Inhibiting Platelet Aggregation with Berries.jpeg

The Global Burden of Disease Study published in 2012, is the most comprehensive and systematic analysis of causes of death undertaken to date, involving nearly 500 researchers from more than 300 institutions in 50 countries, and starting with almost 100,000 data sources. What did the researchers find? Here in the U.S., they determined that our biggest killer was our diet. Number 1 on their list of the most important dietary risks was not eating enough fruit, responsible for an estimated 4.9 million deaths a year around the world.

According to the Union of Concerned Scientists: "If Americans ate just one more serving of fruits or vegetables per day, this would save more than 30,000 lives and $5 billion in medical costs each year." One antidote for individuals is easy, painless, and even pleasurable: exploit the multiple nutritional and protective benefits of fruits and vegetables.

One way plants protect us may be their antiplatelet effects. Platelets are what trigger the blood clots that cause heart attacks and most strokes. And beyond their obvious function in blood clotting, platelets are now considered to play a pivotal inflammatory role in the hardening of the arteries in the first place, and in allergies, rheumatoid arthritis, and even cancer.

Normally, under healthy conditions, platelets circulate in a quiescent, inactive state. But once they become activated, they can emerge as culprits in inflammation. Platelets transport a vast amount of inflammatory chemicals, and upon activation they release these chemicals, which can recruit the inflammatory cells that form the pus pockets within our arterial walls that can eventually burst and kill us.

This involvement of platelet activation in atherosclerosis development is well established. We've long recognized the platelets' role in the final stages; however, a growing body of data indicates that platelets may also play an important role in the initiation and propagation of atherosclerosis in the first place. How can we prevent the excessive activation of platelets? It's generally recognized that platelet hyper-reactivity is associated with high levels of cholesterol circulating in the blood; so we can cut down on foods that have trans fats, saturated fats, and dietary cholesterol.

We can also eat more fruits and vegetables. For example, different varieties of strawberries have shown a significant antiplatelet effect in a petri dish and in people. How did researchers figure it out? In my video, Inhibiting Platelet Aggregation with Berries, you can see a platelet in a resting state, packed with little round granule grenades of inflammatory chemicals, which fuse together and are released when the platelet gets activated. Because resting and activated platelets look so different, we can just take blood from people and count how many are resting and how many are activated before and after people eat more than a pint of strawberries every day for a month. From just adding strawberries to people's diets, there's a small but significant drop in the percentage of activated platelets circulating throughout their bodies.

Other berries had a similar effect, even at a more modest two servings a day. Drinking orange or grapefruit juice doesn't seem to help, but purple grape juice successfully reduces platelet activity on the same order that aspirin does.

Studies have shown that daily aspirin can reduce heart attacks and strokes; however, aspirin can also cause severe gastrointestinal disturbances and bleeding problems, and so should not be used for the primary prevention of heart attacks and stroke as the benefits don't clearly outweigh the serious risks. It's nice to have safe, side-effect free alternatives.


One of the ways plants help keep platelets in their place may actually be their aspirin content! See Aspirin Levels in Plant Foods. Why would a plant make a human drug? It's so cool, check out Appropriating Plant Defenses.

Is the Standard American Diet really so bad that we could save 100,000 people by just getting up to minimum fruit and veggie recommendations? Even cynics might be surprised: Nation's Diet in Crisis. Even more plants may cut deaths even more, though. See One in a Thousand: Ending the Heart Disease Epidemic.

For more on lowering cholesterol see my video Trans Fat, Saturated Fat, and Cholesterol: Tolerable Upper Intake of Zero. And it's never too early to start eating healthier. Check out: Heart Disease Starts in Childhood. Heart disease may be a choice. See: Cavities and Coronaries: Our Choice.

Berries are the healthiest fruits, shown to maintain our brain power (How to Slow Brain Aging By Two Years) and improve our immune function (Boosting Natural Killer Cell Activity). That's one of the reasons we want to eat Antioxidant Rich Foods With Every Meal.

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, From Table to Able, and Food as Medicine.

Image Credit: Michael Stern / Flickr

Original Link

How Plants Can be Both Safer and More Effective

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During the last decade, the drug industry has followed an assumption that a single drug hitting a single target was the "rational" way to design drugs. We're learning that Mother Nature may be a bit too complicated for that. "Strategies for targeting single genes or proteins ignore a very important fact that most, if not all diseases, involve a sophisticated network system." For example, one little family of immune molecules involves about 50 different keys fitting into about 20 different locks, often acting with redundancy, making selection of an appropriate drug to antagonize one key or one lock ineffective in the long run. A whole list of agents has been developed to target a specific molecule for the treatment of inflammatory bowel disease, for example, but they have all flopped. That's why drug companies are now working on so-called "promiscuous" drugs that try to affect multiple pathways simultaneously.

Meanwhile, since ancient times, natural agents derived from plants--fruits, vegetables, spices, beans, and grains--have been preferred as potential therapeutics for most chronic diseases, not only because of their safety, affordability, and long-term use, but also "for their ability to target multiple cell signaling pathways, a therapeutic virtue." (See Magic Bullets vs. Promiscuous Plants).

One example of a successful promiscuous plant-based drug is aspirin. It doesn't just target inflammation and offer pain relief, but can act as a blood thinner and help prevent preeclampsia and even some types of cancer. Curcumin is another hopeful plant-based medicine. Aspirin is an extract of the willow tree bark (and is present in other fruits and vegetables); curcumin is an extract of turmeric root. It's so anti-inflammatory that it may even work through the skin--a traditional use was to wrap sprains and injuries with turmeric soaked poultices, a use that continues to this day. Curcumin is so anti-inflammatory that it can help counter the effects of mustard gas.

In a petri dish, curcumin extinguishes the response of spleen cells to an inflammatory cytokine. Promising effects have also been observed in patients with a variety of inflammatory diseases. One of the great things about curcumin is that it also appears to be very safe. One of the reasons may be that despite its powerful pharmacological effects, the same pathway promiscuity that may account for its effectiveness may act synergistically to neutralize side-effects. For example, turmeric has been traditionally used as a bronchodilator to open airways in conditions like asthma. Many of the adrenaline-like drugs that do the same thing can raise blood pressure. The reason turmeric doesn't may be because it has different components with opposing activities, such as calcium channel-blocking effects that may actually lower blood pressure, and so the side effects may cancel each other out.

This strength in promiscuity, though, is also a weakness. The U.S. Food and Drug Administration has been reluctant to approve plant extracts, which by definition are composed of mixtures of different compounds. It's a Catch-22. One drug, one chemical, one mechanism of action and you can patent it, get FDA approval, and make a billion off it, but it may not work very well. On the other hand, there might be a safe, natural alternative that works better, but industry and the government may not be interested.

However, there is hope on the horizon. The FDA approved a green tea ointment as a prescription drug for the treatment of genital warts (See Treating Genital Warts with Green Tea), making it the first prescription plant approved in the United States. If you think that's neat, check out Treating Gorlin Syndrome With Green Tea.

So have drug companies abandoned their model and started pouring money into plants? No. "Having discovered that so-called magic bullet has been largely unsuccessful, they just propose creating non-selective drugs. Instead of magic bullets, magic shotguns."

I go into more detail about the Catch-22 in my last video Plants as Intellectual Property - Patently Wrong?

Aspirin isn't just found in willow tree bark, but throughout the plant kingdom, including fruits and vegetables. See: Aspirin Levels in Plant Foods.

My video Power Plants shows how plant foods are not to be underestimated.

More on turmeric curcumin and inflammation here:

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my videos for free by clicking here and watch my full 2012 - 2015 presentations Uprooting the Leading Causes of Death, More than an Apple a Day, From Table to Able, and Food as Medicine.

Image Credit: Shu / Flickr

Original Link

How Humans Benefit From Stressed Plants

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Plants live the ultimate sedentary lifestyle--most of us usually think of plants more as objects than as organisms. Because plants can't move, they've had to evolve a whole other way to escape threats to their well-being. Plants can "sense and respond dynamically to all sorts of stimuli: chemical concentrations in the air and soil, water, touch, motion, vibration, pathogens, predators, and, of course, light." How do they respond? Biochemically. They manufacture, from scratch, a dizzying array of compounds to deal with specific threats.

If we get too hot, we can move into the shade. If plants get too hot, they're stuck--they are the shade! As a result, "the complexity of the plant stress response humbles that of animals. Plants and their stress response have been evolving for almost a billion years." And in that time they've created a whole chemistry lab of protective substances, some of which can induce similarly protective responses in those of us who eat them.

The "best grapes in terms of health benefit often grow in relatively dry, sun-exposed, infertile soil. Similarly, drought-stressed strawberries have more antioxidants and phytonutrients. Indeed, commonly consumed foods like lettuce and fruits can be nutritionally enhanced by cold stress, light stress, water deficit, or nutrient deficit stress." Why are stressed plants often the healthiest?

Studies (such as those highlighted in my video, Appropriating Plant Defenses) suggest that plants and animals largely share the same molecular pathways in order to respond to stress, so it's conceivable that a molecule produced in plants can also be effective in people. Plants have DNA; humans have DNA. The UV rays in sunlight can damage the DNA in plants in the same way it can damage our DNA (by creating free radicals). Plants figured out how to cook up all these complex antioxidants, and instead of reinventing the wheel, animals can just expropriate those antioxidants from plants and commandeer them for the same purpose.

We get attacked by bacteria; plants get attacked by bacteria. When a particular fungus is getting muscled in on by bacteria, it creates a molecule called penicillin--provided free for us.

When plants get infected, they produce aspirin (See Aspirin Levels in Plant Foods), which can come in handy when we get infected. Plants heal wounds; we heal wounds, using similar fatty-acid signaling systems. It is "increasingly evident that plants and animals differ less than we thought in how we respond to stimuli, sharing elements of fatty acid, protein, steroidal, neurotransmitter, free radical, nitric oxide, and even plant growth hormone signaling systems." So in a sense, we're just opening up nature's drug store when we pull out the crisper in our fridge.

This whole co-evolution concept reminds me of Human Neurotransmitters In Plants and The Broccoli Receptor: Our First Line of Defense.

More on the power of plants in Power Plants.

Some of the wilder things that Phytochemicals: The Nutrition Facts Missing from the Label can do are explored in:

We evolved eating a lot of plants: Paleolithic Lessons.

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my videos for free by clicking here and watch my full 2012 - 2015 presentations Uprooting the Leading Causes of Death, More than an Apple a Day, From Table to Able, and Food as Medicine.

Image Credit: Hernan Pinera / Flickr

Original Link

How Phytates Fight Cancer Cells

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Phytate is a compound found in beans, grains, nuts and seeds. The average daily intake of phytate in vegetarian diets is about twice that of those eating mixed diets of plant and animal foods, which may help explain their low cancer rates. Aside from helping to prevent cancer, dietary phytate has been reported to help prevent kidney stone formation, protect against diabetes mellitus, dental cavities, and heart disease.

Do all these potentially beneficial effects sound too good to be true? Are there other examples of compounds made by plants that can have benefits across multiple diseases? Why yes! Aspirin, for example, which is found throughout the plant kingdom may also account for a variety of plant-based benefits (See Aspirin Levels in Plant Foods).

But of all the things phytates can do, the anticancer activity of phytate (also known as phytic acid, IP6, or inositol hexaphosphate), is considered one of its most important beneficial activities. Dietary phytates are quickly absorbed from the gastrointestinal tract and rapidly taken up by cancer cells throughout the body, and have been shown to inhibit the growth of all tested cancerous cell lines in vitro. Phytates have been shown to inhibit the growth of human leukemia cells, colon cancer cells, both estrogen receptor-positive and negative breast cancer cells, voicebox cancer, cervical cancer, prostate cancer, liver tumors, pancreatic, melanoma, and muscle cancers. All at the same time not affecting normal cells. That's the most important expectation of a good anticancer agent: the ability to only affect cancerous cells and to leave normal cells alone.

In my video, Phytates for Rehabilitating Cancer Cells, you can see how leukemia cells taken from cancer patients are killed by phytates, whereas normal bone marrow cells, are spared. This may explain why bean extracts kill off colon cancer cells in vitro, but leave normal colon cells alone.

What are the mechanisms of action by which phytates battle cancer? In other words, how do phytates fight? How don't they fight? Phytate targets cancer through multiple pathways, a combination of antioxidant, anti-inflammatory, immune-enhancing activities, detox, differentiation, and anti-angiogenesis. In other words, phytate appears to affect all the principal pathways of malignancy.

The antioxidative property is one of the most impressive characteristics of phytate. In fact that's why the meat industry adds phytates to meat to prevent the fat oxidation that begins at the moment of slaughter. Phytates can also act on our immune functions by augmenting natural killer cell activity, the cells in our body that hunt down and dispose of cancer cells, as well as neutrophils, which help form our first line of defense. And then phytates starve tumors as more of a last line of defense. Not only can phytates block the formation of new blood vessels that may be feeding tumors, but disrupt pre-formed capillary tubes, indicating that phytates may not just help blockade tumors, but actively cut off existing supply lines.

What's really remarkable about phytate, though, is that unlike most other anti-cancer agents, it not only causes a reduction in cancer cell growth but also enhances differentiation, meaning it causes cancer cells to stop acting like cancer cells and go back to acting like normal cells. You can see this with colon cancer cells for example. In the presence of phytates, human colon cancer cells mature to structurally and behaviorally resemble normal cells. And this has been demonstrated in leukemia cells, prostate cancer, breast cancer, and muscle cancer cells as well.

For more on the cancer and phytate connection, check out Phytates for the Prevention of Cancer and Phytates for the Treatment of Cancer.

This video reminds me of my video on the spice, turmeric, Turmeric Curcumin Reprogramming Cancer Cell Death.

What else can we eat to improve the cancer-fighting front of our immune system? See Boosting Natural Killer Cell Activity.

More on the concept of starving tumors of their blood supply in Anti-Angiogenesis: Cutting Off Tumor Supply Lines.

Is there clinical evidence of plants actually reversing cancer progression? You won't believe your eyes:

-Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, and From Table to Able.

Image Credit: Avi / Flickr

Original Link

Why Pepper Boosts Turmeric Blood Levels

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"Historians from all around the world have produced evidence to show that apparently all primitive peoples used herbs-often in a sophisticated way. Quinine from Cinchona bark was used to treat the symptoms of malaria long before the disease was identified, and the raw ingredients of a common aspirin tablet have been a popular painkiller for far longer than we have had access to tablet-making machinery. Indeed, today many pharmacological classes of drugs include a natural product prototype that we originally discovered through the study of traditional cures and folk knowledge of indigenous people."

There's a plant in South Asia called Adhatoda (from adu meaning "goat," and thoda meaning "not touch" because it's so bitter even the goats won't eat it). It has compounds that help open one's airways and as such, Adhatoda tea has been used traditionally to treat asthma, where the leaves are steeped with black peppercorns. Leaves steeped with black peppercorns? That sounds gross to me--why would they do that? Because they're smart. Back in 1928, scientists discovered what the people evidently already knew, that adding pepper increased the anti-asthmatic properties of the leaves. Black pepper alone didn't work: it was the combination. And now we know why.

Just like approximately 5% of the spice turmeric is composed of an active compound called curcumin, about 5% of black pepper by weight is comprised of this compound called piperine. Curcumin is responsible for the yellow color of turmeric and piperine for the pungent flavor of pepper. Piperine is a potent inhibitor of drug metabolism. One of the ways our liver gets rid of foreign substances is making them water soluble so they can be more easily excreted. But this black pepper molecule inhibits that process.

And it doesn't take much. If people are given a bunch of turmeric curcumin, within an hour there's a little bump in the level in their blood stream. We don't see a large increase because our liver is actively trying to get rid of it. But what if the process is suppressed by taking just a quarter teaspoon's worth of black pepper? Then you see curcumin levels skyrocket (See Boosting the Bioavailability of Curcumin). The same amount of curcumin consumed, but the bioavailability shoots up 2000%. Even just a little pinch of pepper--1/20th of a teaspoon--can significantly boost levels. And guess what a common ingredient in curry powder is besides turmeric? Black pepper.

Another way to boost the absorption of curcumin is to consume it in the whole food, turmeric root (fresh or dried as a powder) because natural oils found in turmeric root and turmeric powder can enhance the bioavailability of curcumin seven to eight fold. When eaten with fat, curcumin can be directly absorbed into the bloodstream through the lymphatic system thereby in part bypassing the liver.

How is it prepared in India? With fat and black pepper. Amazing how they could figure that out without double blind trials. (Though maybe it just tastes good, and it's merely coincidence?) Their traditional knowledge certainly failed them with ghee, however, which is practically pure butter fat, which may explain India's relatively high rates of heart disease despite all their turmeric.

Why would we care about boosting curcumin levels? Learn why in my videos Which Spices Fight Inflammation? and Spicing Up DNA Protection, Turmeric Curcumin and Rheumatoid Arthritis, and Turmeric Curcumin and Osteoarthritis. It's also good to know Who Shouldn't Consume Curcumin or Turmeric.

I've previously covered this topic of food synergy in videos such as Apples and Oranges: Dietary Diversity and Garden Variety Anti-Inflammation that emphasize the importance of eating a variety of plant foods to take advantage of some of these interactions.

The black pepper mechanism reminds me of the grapefruit (Tell Your Doctor If You Eat Grapefruit) and broccoli (The Best Detox) stories. A testament to the power of plants.

The painkilling properties of aspirin mentioned in the video are actually found throughout the plant kingdom: Aspirin Levels in Plant Foods.

In some circumstances, traditional medicine wisdom seems incredible (Tomato Effect); in others, dangerous (Get the Lead Out). But that's what we now have science for!

-Michael Greger, M.D

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, and From Table to Able.

Image Credit: John Loo / Flickr

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Foods With Natural Melatonin

 

 

 

 

 

 

 

 

Foods With Natural Melatonin

We know that inadequate sleeping is associated with changes in diet—people tend to eat worse—but what about the opposite question: Can food affect sleep? In a study on kiwifruit, this seemed possible (see Kiwifruit For Insomnia), but the mechanism the researchers suggested for the effect—the serotonin levels in kiwifruit—doesn’t make any sense, since serotonin can’t cross the blood-brain barrier. We can eat all the serotonin we want and it shouldn’t affect our brain chemistry. A different brain chemical, though, melatonin, can get from our gut to our brain.

Melatonin is a hormone secreted at night by the pineal gland in the center of our brain to help regulate our circadian rhythm. Supplements of the stuff are used to prevent and reduce jet lag, and about 20 years ago MIT got the patent to use melatonin to help people sleep. But melatonin "is not only produced in the pineal gland—it is also naturally present in edible plants."

That might explain the results of a study, “Effects of a Tart Cherry Juice Beverage on the Sleep of Older Adults with Insomnia” (See Tart Cherries for Insomnia). The research group had been doing an earlier study on tart cherry juice as a sports recovery drink. There’s a phytonutrient in cherries with anti-inflammatory effects on par with drugs like aspirin and ibuprofen, so the researchers were trying to see whether tart cherry juice could reduce muscle soreness after exercise. During the study, some of the participants anecdotally noted that they were sleeping better on the cherries. That was unexpected, but the researchers realized that cherries were a source of melatonin so they put them to the test.

The reason they chose older subjects is that melatonin production tends to drop as we age, which may be one reason why there’s a higher insomnia rates among the elderly. So, they took a group of older men and women suffering from chronic insomnia and put half on cherries and half on placebo. They couldn’t use whole cherries for the study—how could you fool people with a placebo cherry? So they used cherry juice versus cherry Kool-Aid.

They found that participants did in fact sleep a little better on the cherry juice. The effect was modest, but significant. Some, for example, fell to sleep a few minutes faster and had 17 fewer minutes of waking after sleep onset (waking up in the middle of the night). It was no insomnia cure, but it helped—without side effects.

How do we know it was the melatonin, though? They repeated the study, this time measuring the melatonin levels, and indeed saw a boost in circulating melatonin levels after the cherry juice, but not after the Kool-Aid. Similar results were found in people eating the actual cherries—seven different varieties boosted melatonin levels and actual sleep times. The effects of all the other phytonutrients in cherries can’t be precluded—maybe they helped too—but if it is the melatonin, there are more potent sources than cherries.

Orange bell peppers have a lot, as do walnuts—and a tablespoon of flaxseeds has about as much as a tomato. See the chart in my video Tart Cherries for Insomnia. The melatonin content of tomatoes was suggested as one of the reasons traditional Mediterranean diets were so healthy. They have less melatonin than the tart cherries, but people may eat a lot more tomatoes than cherries. Sweet cherries have 50 times less melatonin than tart ones; dried cherries appear to have none.

A few spices are pretty potent: just a teaspoon of fenugreek or mustard seeds has as much as a few tomatoes.  The bronze and silver go to almonds and raspberries, though. And the gold goes to gojis. Goji berries were just off the charts.

Aren’t goji berries really expensive, though? Not if you buy them as lycium berries. Check out my video Are Goji Berries Good for You?

I’ve previously explored Human Neurotransmitters in Plants in the context of boosting serotonin levels in the brain to improve mood. See:

Melatonin may also play a role in cancer prevention. See Melatonin & Breast Cancer. 

-Michael Greger, M.D.

PS: If you haven’t yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death and More Than an Apple a Day.

Image credit: Elizabeth / Flickr

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